Summer Registration Form Class/Camp   

Student: ________________________________  Age:_______ DOB: __________    M  / F

Parent/Guardian: _________________________  Contact # __________________ (emergency)

Email __________________________________  Address _______________________________

·          Please list any medical conditions that the staff at XDA should be aware of such as allergies, asthma, or any medications that your child is on. ____________________________________________________________________ 

·          XDA does not carry medical insurance for its students. Each student is required to be covered by their own family medical policy, and if an injury occurs it is understood that the students own policy is their only source of reimbursement. 

___________________________________________________   Date: ________________________

Select Session (s) Below   

6 Week Summer Class Session Begins June 15^th (Closed the week of July 5^th-9^th) Held on Tuesdays

Cost Based on # of Hours taken and is prorated for the six weeks.

Advanced Tumble/Acro   4:00-5:00 (rm1)        ________                                                             Ballet/Tap 3 5:15-6:00 (rm2)                      _________ 

Intro to Hip Hop  5:00-5:45 (rm1)                            ________                                                       Beginner Tumble 3-5 6:00-6:30 (rm2)         _________ 

Int. Hip Hop   5:45-6:60 (rm1                                       ________                                                      Age 5-7 Jazz/Ballet   6:30-7:15 (rm2)       _________ 

Jazz/Lyrical   6:30-7:30  (rm1)                                       ________                                                               

TEAM Ballet/Technique   7:30-9:00  (rm1)  Required for team members  ________ 

Day Camps & Workshops  

All camps & workshops require a non-refundable $25 deposit due at the time of registration.   

Disney Mania Dance & Tumble – Ages 6-10  ______

June 21^st -25^th Full Day 8:00-5:00pm / Cost $200.00 / Snacks, Crafts and Field Trip included in price.

Advanced Dance/Technique Workshop  ______   

June 28^th-July 2^nd Half Day 8:00-12:00pm / Cost $150.00 / Geared towards dancers that wish to talk their technique & ability to the next level!

Dance Team Choreography Workshop (Required) ______   

July 12^th-13^th-15^th-16^th 4 days / Cost $150.00 / All dance team members are required to attend

Hip Hop Team Choreography (Required)  _______   

All Cost $75.00   Junior Team-July 20^th-22^nd 9am-12pm  /  Senior Team-July 20^th-22^nd 1-4pm  /  Teen Team July 27^th-29^th 1-4pm

Dance Team Workshop  (Required)   ______  

August 2^nd-4^th 8:00am-12:00pm / Price & Schedule TBA…..Guest Instructors!!!!